A COMPARATIVE STUDY OF MIDAZOLAM, PROPOFOL AND DEXMEDETOMIDINE INFUSIONS FOR SEDATION IN ME- CHANICALLY VENTILATED PATIENTS IN ICU
|
|
- Jeffery Norris
- 5 years ago
- Views:
Transcription
1 ORIGINAL ARTICLE A COMPARATIVE STUDY OF MIDAZOLAM, PROPOFOL AND DEXMEDETOMIDINE INFUSIONS FOR SEDATION IN ME- CHANICALLY VENTILATED PATIENTS IN ICU Suresh Chandra Dulara 1, Pooja Jangid 2, Ashish Kumar Jangir 3 Author s Affiliations: 1 Senior Professor; 2 Post PG, Anesthesia, GMC Kota, Rajasthan; 3 DNB Student, Endocrinology, KIMS, Secunderabad Correspondence: Dr. Pooja Jangid, pooja.rgmc@gmail.com ABSTRACT Background: This study was aimed to compare the sedative properties of study drugs- midazolam, propofol and dexmedetomidine in critically ill patients with GCS of on invasive mechanical ventilation. Methodology: This study was carried out in 75 adult patients with Glasgow coma scale score of 12-15, on mechanical ventilation. The study patients were divided into 3 groups with each group consisting of 25 patients- Group M received inj. Midazolam loading dose 0.15mg/kg intravenous followed by continuous infusion of mg/kg/hr, Group P received inj. Propofol loading dose 1.5mg/kg intravenous followed by continuous infusion of 1-6 mg/kg/hr and Group D received inj. Dexmedetomidine loading dose 1µg/kg intravenous followed by continuous infusion of µg/kg/hr. All patients were given study drug infusion for 48 hours to achieve Richmond Agitation Sedation Scale Score 0 to -2. Assessment of RASS score, mean pulse rate, mean arterial pressure, total respiratory rate and SpO 2 were monitored initially at 5 min interval after the loading dose is given, till 30 minutes, then at 1 st hour and 2 nd hour, then at 6 th hour and 12 th hour, then every 12 th hour till 48 hour. Results: The mean pulse rate and mean arterial pressure decreased after giving loading dose in all three groups and it was more in dexmedetomidine group which continued to be significant till 20 and 30 minutes respectively. RASS remained in the target range of 0 to -2 in all the three groups throughout the sedation period of 48 hours by their infusion doses. Conclusion: With dexmedetomidine similar levels of sedation can be achieved as compared to propofol and midazolam. All the three drugs are equally efficacious in regard to cardiorespiratory stability in maintaining target sedation (RASS 0 to -2) in mechanically ventilated patients in ICU. Key words: Midazolam, Propofol, Dexmedetomidine, Infusions, Mechanical Ventilation, Sedation, ICU. INTRODUCTION One of the key factors for good clinical practice in the intensive care unit is to provide sedation to ensure patient comfort. Sedation in intensive care patient is assumed to reduce discomfort from critical care interventions, to increase tolerance of mechanical ventilation, to prevent accidental removal of instrumentation, to suppress cough response to prevent fighting against ventilator and to reduce metabolic demands during cardiovascular and respiratory instability. 1 The fight against ventilator causes dyssynchrony between patient and ventilator which leads to anxiety, tachycardia, high blood pressure, lung injury (ALI) to the patient. This causes prolongation of intensive care unit stay, increases the cost and worsens the prognosis of the patient. The goal of sedation in ICU is to have a cooperative and reasonably calm patient who will not harm himself or interfere with ICU care. 2 NJMR Volume 5 Issue 3 July Sept 2015 Page 234
2 Ideal sedative agent for sedation in ICU patients should have the properties like rapid onset and offset of action, minimal cardiovascular side effects, controllable respiratory side effects, no accumulation in renal or hepatic dysfunction, inactive metabolites, cheap in cost and no interaction with other intensive care unit drugs. No drug with all these properties exist and therefore there is a need to find a better agent which has maximum properties meeting the ideal sedative agent for use in patients on ventilator. 3 This study was intended to find effectiveness and potency, haemodynamic stability, safety and occurrence of any complication of the three commonly used sedative drugs propofol, midazolam and dexmedetomidine in mechanically ventilated patients in need of moderate sedation in ICU set up. METHODOLOGY Approval from ethical committee of Government medical college and associated group of hospitals, Kota, (Raj.), India was obtained for this study. Written informed consent from all the patient s attendant were obtained. This prospective randomized clinical study was carried out in 75 adult patients with Glasgow coma scale score of 12-15, who were on mechanical ventilation in clinical need for light to moderate sedation. Patients with severe neurological disorder with GCS< 12, mean arterial pressure less than 50 mmhg despite appropriate volume replenishment, heart rate <50/min, with renal or hepatic failure, or sensitivity with any of study drug were not included in this study. Patients who died even after critical care were not included in this study. Patients were divided into three groups of 25 each. Group M patients received IV inj. Midazolam loading dose 0.15mg/kg followed by maintenance dose of mg/kg/hr by continuous infusion by infusion pump. Group P patients received intravenous inj. Propofol loading dose of 1.5mg/kg followed by continuous infusion of 1-6 mg/kg/hr. Group D patients recieved intravenous inj. Dexmedetomidine loading dose of 1µg/kg followed by maintenance dose of µg/kg/hr of continuous infusion by infusion pump. All the patients received inj. Tramadol 100 mg TDS intravenous every 8 hourly. Desired depth of sedation was assessed by RASS score. 4 All the patients were given study drug bolus and then infusion for 48 hours to keep Richmond Agitation Sedation Scale Score 0 to -2. Tidal volume was set to 8 ml/kg. Mode of ventilation was set to SIMV. RASS score, mean pulse rate, mean arterial pressure, total respiratory rate and SpO2 were noted initially at 5 min interval after the loading dose till 30 minutes, then at 1 hour and 2 hour, then at 6 th hour and 12 th hour and then every 12 th hour till 48 hour. Complications like bradycardia (PR<60/min), hypotension (MAP<60 mmhg), respiratory depression, etc. were closely observed and managed accordingly. Statistical analyses: All results were expressed as mean ± SD (standard deviation). ANOVA (One- Way Analysis of Variance) test was used for independent variables with normal distribution. Microsoft Excel 2007 with SPSS Statistics software used for statistical analysis. P<0.05 was considered statistically significant. RESULTS There were no significant difference in demographic data and diagnosis/reason for mechanical ventilation, between the three groups as shown in table 1 and 2. Table 1: Demographic Profile Variable Group D (Mean±SD) Group M (Mean±SD) Group P (Mean±SD) Age (yrs) 37.16± ± ±2.522 Wight(kgs) 62.76± ± ±1.95 Sex(M/F) 15/10 16/9 15/10 Table 2: Diagnosis of patients requiring endotracheal intubation and SIMV mode of ventilation DIAGNOSIS Group D (%) (N= 25) Group M (%) (N=25) Group P (%) (N=25) ARDS 3 (12) 3 (12) 4 (16) Acute exacerbation of copd 7 (28) 6 (24) 7 (28) Aspiration pneumonitis 6 (24) 4 (16) 5 (20) Acute LVF 1 (4) 2 (8) 1 (4) Post operative respiratory depression 4 (16) 4 (16) 3 (12) Seizures 3 (12) 4 (16) 4 (16) Snake bite 1 (4) 2 (8) 1 (4) NJMR Volume 5 Issue 3 July Sept 2015 Page 235
3 Table 3: Comparison of mean pulse rate (/min) at different time interval ( in MEAN±SD) TIME GROUP D GROUP M GROUP P p-value PRE SEDATION IMMEDIATELY AFTER AFTER 5MIN MIN < MIN < MIN MIN MIN HR HR HR HR HR HR HR As shown in table number 3, in Group D, mean pulse rate was ± 9.82, in Group M mean pulse rate was ± and in Group P mean pulse rate was ± before starting of sedation which was found to be statistically insignificant (P.81). The mean pulse rate decreased after giving loading dose in all three groups. The mean pulse rate remained below base line throughout the sedation period in all three groups. The fall in mean pulse rate was more in dexmedetomidine group after loading dose which continued to be significant till 30 minutes of sedation as compared to midazolam and propofol group. The maximum fall in mean pulse rate was found at 15 minutes. After 30 minutes of sedation, the change in mean pulse rate was statistically insignificant when the three study groups were compared at the different time intervals. Table 4: Comparison of mean arterial pressure (map, mm hg) at different time interval (in MEAN ±SD) TIME GROUP D GROUP M GROUP P p-value PRE SEDATION 87.28± ± ± IMMEDIATELY AFTER 74.16± ± ± AFTER 5MIN 70.56± ± ± MIN 71.08± ± ± MIN 71.56± ± ± MIN 72.92± ± ± MIN 73.76± ± ± MIN 74.68± ± ± HR 76.2± ± ± HR 77.76± ± ± HR 78.8± ± ± HR 78.8± ± ± HR 79.52± ± ± HR 79.16± ± ± HR 80± ± ± As shown in table number 4, in Group D, mean arterial pressure was ± 6.45, in Group M, mean arterial pressure was 88.4 ± 6.75 and in Group P mean arterial pressure was ± 6.36 before starting of sedation which was found to be statistically insignificant (P= 0.827). Mean arterial pressure reduced in all three groups after giving the loading dose and remained below baseline throughout the 48 hour sedation period in all three groups. Fall in MAP was more in dexmedetomidine group after loading NJMR Volume 5 Issue 3 July Sept 2015 Page 236
4 dose which continued to be significant till 20 minutes of sedation as compared to midazolam and propofol group. After 20 minutes of sedation, the change in MAP was statistically insignificant when the three study groups were compared at the different time intervals. Total respiratory rate and Spo 2 : It was noted as total of patient s own rate plus ventilator rate. Respiratory rate was decreased in all the groups after sedation was started but respiratory depression was not found in any group. Mean respiratory rate remained above 18 in all three groups. SpO 2 remained above 97 % at all time intervals in all three groups. When the groups were compared at different time intervals, p value was more than 0.05 which was statistically insignificant for both RR and SpO 2. Table 5: Comparison of RASS at different time interval (in MEAN ± SD) TIME GROUPD GROUPM GROUP P p-value PRE SEDATION 1.92± ± ± IMMEDIATLY AFTER 0.52± ± ± AFTER 5MIN 0.12± ± ± MIN -0.28± ± ± MIN -0.96± ± ± MIN -1.32± ± ± MIN -1.52± ± ± MIN -1.72± ± ± HR -1.84± ± ± HR -1.84±0.37-2±0-1.8± HR -1.84± ± ± HR -1.96± ± ± HR -2.12± ± ± HR -2.04± ± ± HR -1.16± ± ± Table 6: complications and interventions used to manage complications Complication Intervention Group D Group M Group P Bradycardia Sedative drug dose reduction Atropine 1 Nil Nil Hypotension Sedative drug dose reduction Iv fluids As shown in table number 5 and figure 1, RASS of 0 was attained immediately after loading dose in all three groups but deeper sedation level of RASS -2 was achieved at 15 minute in propofol group whereas it was achieved at 20 minutes in both dexmedetomidine and midazolam group. RASS remained in the target range of 0 to -2 in all the three groups throughout the sedation period. Whenever RASS reached above -2, dose reduction was done to maintain it between 0 to -2. As shown in table above, when the three groups were compared with respect to RASS maintained at different time intervals, the difference was found to be statistically insignificant ( p >0.05). As shown in table 6,in group D, bradycardia was found in 6 patients out of 25, but only one patient required treatment with atropine whereas rest 5 patients required only sedative drug dose reduction. In group M bradycardia was found in 1 patient and in group P, bradycardia was found in 2 patients out of 25, but it was treated by sedative drug dose reduction in both group P and M and no patient required use of atropine. In group D, hypotension was found in 5 patients and all of them were treated with IV fluids and dose reduction. In group M, hypotension was found in 2 patients and in group P, it was found in 3 patients. All were treated with drug dose reduction and IV fluids. None of the patients in any of groups required vasopressor. This showed that incidence of hypotension and bradycardia was more in dexmedetomidine group followed by propofol and then midazolam. None of the patients in all the groups showed the incidence of respiratory depression. NJMR Volume 5 Issue 3 July Sept 2015 Page 237
5 RASS GROUP GROUP GROUP D M P P.S I.A AFTER 5MIN 10 MIN 15 MIN 20 MIN 25 MIN 30 MIN 1 HR 2 HR 6 HR 12 HR 24 HR 36 HR 48 HR Figure 1: Comparison of RASS between patients on midazolam (M), propofol(p) and dexmedetomidine(d) sedative infusions, before starting of sedation, at 5 min interval after the loading dose till 30 minutes, then at 1st hour and 2 nd hour, then at 6 th hour and 12 th hour and then every 12 th hour till 48 hours. DISCUSSION For the past decades, Gamma aminobutyric acid (GABA) receptor agonists (including propofol and benzodiazepine midazolam) have been the standard of care for sedation in the intensive care unit (ICU). 5 However, GABA-mimetic sedatives have significant limitations including delirium, respiratory depression, dependence and withdrawal. 6 Midazolam has less active metabolites and faster elimination process but is of limited use because of the variability in duration of time for attaining consciousness after stopping the drug infusion in some patients. Propofol has a rapid distribution, metabolism and elimination process. But its prolonged infusions can lead to propofol infusion syndrome. Dexmedetomidine, a central and peripheral α2-receptor agonist distinct from GABA receptor for benzodiazepines and propofol, has been approved by the US Food and Drug Administration in mechanically ventilated patients. 7 It lacks suppression of the respiratory drive and does not depress the neurologic status, resulting in a state of cooperative sedation and preservation of neutrophil function. However, stimulation of the central Alpha 2 receptors can lead to bradycardia and hypotension especially in volumedepleted patients. Of note, its sympatholytic action can blunt the stress response in critically ill patients. This study was intended to find a better ICU sedation protocol for ICU patients in our set up. We also intended to find effectiveness and potency of sedative property, haemodynamic stability and safety, and occurrence of any complication, of the three study drugs propofol, midazolam and dexmedetomidine, in mechanically ventilated patients in need of moderate sedation in ICU set up. Our study showed that fall in mean pulse rate and mean arterial pressure was found in all three drugs after loading dose. The fall in mean PR and MAP was more in dexmedetomidine group after loading dose which continued to be significant till 30 and 25 minutes of sedation respectively as compared to midazolam and propofol group. After that, the change in mean PR and MAP was statistically insignificant when the three study groups were compared at the different time intervals. This also showed that the incidence of complications of hypotension and bradycardia was more in dexmedetomidine group patients. Likewise, in 2012, Jakob SM et al 8 found that dexmedetomidine patients had more hypotension and bradycardia as compared to propofol and midazolam. In 2009, Riker RR, Shehabi Y, Bokesch PM, et al 9 also found that the most notable adverse effect of dexmedetomidine was bradycardia. Jakob SM et al 8 also reported that dexmedetomidine did not cause any respiratory depression and NJMR Volume 5 Issue 3 July Sept 2015 Page 238
6 midazolam and propofol also did not cause a significant decrease in RR in long term sedation. Similar results were obtained in our study also. RASS remained in the target range of 0 to -2 in all the three groups throughout the sedation period of 48 hours by their infusion doses. Dexmedetomidine in the infusion dose range ug/kg /hour was able to maintain the target RASS. Midazolam in the infusion dose range of 0.06 to 0.08 ug/kg/hour and propofol in the infusion dose range of 4-5 mg/kg/hour was able to maintain target RASS. In 2009, Ruokonen E, et al 10 found that in long term sedation, dexmedetomidine is comparable to propofol midazolam in maintaining sedation targets of RASS 0 to -3 but not suitable for deep sedation (RASS - 4 or less). Also the study by Jakob SM et al 8 concluded that dexmedetomidine was not inferior to midazolam and propofol in maintaining light to moderate sedation. CONCLUSION It can be concluded that with dexmedetomidine similar levels of sedation can be achieved as compared to propofol and midazolam. All the three drugs- Midazolam, Propofol and Dexmedetomidine, caused fall in mean heart rate and mean arterial pressure but patients remained clinically stable. Fall was more with dexmedetomidine group but upto 30 minutes of sedation. Later on it was comparable to midazolam and propofol group. Dexmedetomidine group had more incidence of bradycardia and hypotension. All the three drugs maintained the respiratory parameters throughout the sedation period. Thus all the three drugs are equally efficacious and safe in regard to cardiorespiratory stability in maintaining target sedation in mechanically ventilated patients in ICU. REFERENCES 1. Sydow M, Neumann P. Sedation for the critically ill. Intensive Care Med. 1999; 25(6): Rao SM. Analgesics and Sedatives in ICU. expresshealth.in Nov.; 110: Gavin Werrett, derriford hospital, Plymouth, uk. Update in anaesthesia/ sedation in intensive care patients. Issue 16(2003); Article 5: page1. 4. Sessler CN, Gosnell M, Grap MJ, Brophy GT, O'Neal PV, Keane KA, et al. The Richmond AgitationSedation Scale: validity and reliability in adult. Intensive care patients. Am J Respiratory Critical Care Med 2002; 166: Jacobi J, Fraser GL, Coursin DB, Riker RR, Fontaine D, Wittbrodt ET, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002; 30: Pandharipande P, Shintani A, Peterson J, Pun BT, Wilkinson GR, Dittus RS, et al. Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients. Anesthesiology.2006; 104: Precedex (Dexmedetomidine) Lake Forest, IL: Hospira; Product information. 8. Jakob SM, Ruokonen E, Grounds RM, Sarapohja T, Garratt C, Pocock SJ, Bratty JR, Takala J. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA Mar 21; 307(11): Riker RR, Shehabi Y, Bokesch PM, Ceraso D, Wisemandle W, Koura F, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA Feb 4; 301 (5): Ruokonen E, Parviainen I, Jakob SM, Nunes S, Kaukonen M, Shepherd ST, Sarapohja T, Bratty JR, Takala J. Dexmedetomidine versus propofol/ midazolam for long-term sedation during mechanical ventilation, Intensive Care Med Feb;35(2): NJMR Volume 5 Issue 3 July Sept 2015 Page 239
Propofol vs Dexmedetomidine
Propofol vs Dexmedetomidine A highlight of similarities & differences Lama Nazer, PharmD, BCPS Critical Care Clinical Pharmacy Specialist King Hussein Cancer Center Outline Highlight similarities and differences
More informationASMIC 2016 DEXMEDETOMIDINE IN THE INTENSIVE CARE UNIT DR KHOO TIEN MENG
ASMIC 2016 DEXMEDETOMIDINE IN THE INTENSIVE CARE UNIT DR KHOO TIEN MENG PREAMBLE : EVOLUTION OF SEDATION IN THE ICU 1980s : ICU sedation largely extension of GA No standard approach, highly variable Deep
More informationComparison of dexmedetomidine and propofol in mechanically ventilated patients with sepsis: A pilot study
Original article Comparison of dexmedetomidine and propofol in mechanically ventilated patients with sepsis: A pilot study Mark B. Sigler MD, Ebtesam A. Islam MD PhD, Kenneth M. Nugent MD Abstract Objective:
More informationTherapeutics and clinical risk management (2011) Vol.7:291~299. Dexmedetomidine hydrochloride as a long-term sedative.
Therapeutics and clinical risk management (2011) Vol.7:291~299. Dexmedetomidine hydrochloride as a long-term sedative Kunisawa Takayuki Therapeutics and Clinical Risk Management open access to scientific
More informationSusan Becker DNP, RN, CNS, CCRN, CCNS Marymount University, Arlington, VA
Susan Becker DNP, RN, CNS, CCRN, CCNS Marymount University, Arlington, VA Disclosures Study and presentation has no commercial bias or interests No financial relationship with a commercial interest, products,
More informationNIH Public Access Author Manuscript J Crit Care. Author manuscript; available in PMC 2013 July 28.
NIH Public Access Author Manuscript Published in final edited form as: J Crit Care. 2009 December ; 24(4): 568 574. doi:10.1016/j.jcrc.2009.05.015. A new dosing protocol reduces dexmedetomidine-associated
More informationDisclosures. Dexmedetomidine: The Good, The Bad and The Delirious. The Delirious. Objectives. Characteristics of Delirium. Definition of Delirium
Dexmedetomidine: The Good, The Bad and The Delirious Disclosures! I have no actual or potential conflict of interest in relation to this presentation. By John J. Bon, Pharm.D., BCPS Lead Clinical Pharmacist,
More informationClinical effectiveness of a sedation protocol minimizing benzodiazepine infusions and favoring early dexmedetomidine: A before-after study
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2015 Clinical effectiveness of a sedation protocol minimizing benzodiazepine infusions and favoring early dexmedetomidine:
More informationAppendix: Outcomes when Using Adjunct Dexmedetomidine with Propofol Sedation in
SUPPLEMENTAL CONTENT Appendix: Outcomes when Using Adjunct Dexmedetomidine with Propofol Sedation in Mechanically Ventilated Surgical Intensive Care Patients Table of Contents Methods Summary of Definitions
More informationAshraf Darwish, Rehab Sami, Mona Raafat, Rashad Aref and Mohamed Hisham
Dexmedetomidine versus Propofol for Monitored Anesthesia Care In Patients Undergoing Anterior Segment Ophthalmic Surgery Under Peribulbar Medial Canthus Anesthesia Ashraf Darwish, Rehab Sami, Mona Raafat,
More informationDexmedetomidine. Dr.G.K.Kumar,M.D.,D.A., Assistant Professor, Madras medical college,chennai. History
Dexmedetomidine Dr.G.K.Kumar,M.D.,D.A., Assistant Professor, Madras medical college,chennai Dexmedetomidine is the most recently released IV anesthetic. It is a highly selective α 2 -adrenergic agonist
More informationComparison of Intensive Care Unit Sedation Using Dexmedetomidine, Propofol, and Midazolam
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/24 Comparison of Intensive Care Unit Sedation Using Dexmedetomidine, Propofol, and Midazolam Gajendra Singh, Kakhandki
More informationDOI /yydb medetomidine a review of clinical applications J. Curr Opin Anaesthesiol
1573 medetomidine a review of clinical applications J. Curr Opin Anaesthesiol 2008 21 4 457-461. 6 DAHMANI S PARIS A JANNIER V et al. Dexmedetom- 2. α 2 idine increases hippocampal phosphorylated extracellular
More informationPain Management in Racing Greyhounds
Pain Management in Racing Greyhounds Pain Pain is a syndrome consisting of multiple organ system responses, and if left untreated will contribute to patient morbidity and mortality. Greyhounds incur a
More informationPDF of Trial CTRI Website URL -
Clinical Trial Details (PDF Generation Date :- Sun, 10 Mar 2019 06:52:14 GMT) CTRI Number Last Modified On 29/07/2016 Post Graduate Thesis Type of Trial Type of Study Study Design Public Title of Study
More informationCorresponding author: V. Dua, Department of Anaesthesia, BJ Wadia Hospital for Children, Parel, Mumbai, India.
Comparative evaluation of dexmedetomidine as a premedication given intranasally vs orally in children between 1 to 8 years of age undergoing minor surgical procedures V. Dua, P. Sawant, P. Bhadlikar Department
More informationDepartment of Intensive Care Medicine, Austin Hospital and the University of Melbourne, 145 Studley Road, Heidelberg, Victoria, 3084, Australia
Available online http://ccforum.com/content/13/3/r75 Vol 13 No 3 Research Open Access Dexmedetomidine vs. haloperidol in delirious, agitated, intubated patients: a randomised open-label trial Michael C
More informationSafety and Efficacy of Dexmedetomidine, Ketofol, and Propofol for Sedation of Mechanically Ventilated Patients
Research Article imedpub Journals http://www.imedpub.com Journal of Intensive and Critical Care ISSN 2471-8505 DOI: 10.21767/2471-8505.100118 Abstract Safety and Efficacy of Dexmedetomidine, Ketofol, and
More informationSCIENTIFIC COOPERATIONS MEDICAL WORKSHOPS July, 2015, Istanbul - TURKEY
21-22 July, 2015, Istanbul - TURKEY PROSPECTIVE EVALUATION OF CORRELATION OF DEPTH OF DEXMEDETOMIDINE SEDATION AND CLINICAL EFFECTS FOR RECONSTRUCTIVE SURGERIES UNDER REGIONAL ANAESTHESIA Alma Jaunmuktane
More informationSafety and efficacy of dexmedetomidine for long-term sedation in critically ill patients
J Anesth (2014) 28:38 50 DOI 10.1007/s00540-013-1678-5 ORIGINAL ARTICLE Safety and efficacy of dexmedetomidine for long-term sedation in critically ill patients Makoto Ozaki Junzo Takeda Keiji Tanaka Yasuhiro
More informationPremedication with alpha-2 agonists procedures for monitoring anaesthetic
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Premedication with alpha-2 agonists procedures for monitoring anaesthetic Author : Lisa Angell, Chris Seymour Categories :
More informationAlfaxan. (alfaxalone 10 mg/ml) Intravenous injectable anesthetic for use in cats and dogs. TECHNICAL NOTES DESCRIPTION INDICATIONS
Alfaxan (alfaxalone 10 mg/ml) Intravenous injectable anesthetic for use in cats and dogs. NADA 141-342, Approved by FDA ALFAXAN (Schedule: C-IV) (alfaxalone 10 mg/ml) Intravenous injectable anesthetic
More informationOriginal Article Effects of low dose midazolam on bradycardia and sedation during dexmedetomidine infusion
Int J Clin Exp Med 2016;9(6):11838-11844 www.ijcem.com /ISSN:1940-5901/IJCEM0020616 Original Article Effects of low dose midazolam on bradycardia and sedation during dexmedetomidine infusion Yun-Sic Bang
More informationWhat dose of methadone should I use?
What dose of methadone should I use? Professor Derek Flaherty BVMS, DVA, DipECVAA, MRCA, MRCVS RCVS and European Specialist in Veterinary Anaesthesia SPC dose rates for Comfortan dogs: 0.5-1.0 mg/kg SC,
More informationA Clinical Study of Dexmedetomidine under Combined Spinal Epidural Anaesthesia at a Tertiary Care Hospital
Original Research A Clinical Study of Dexmedetomidine under Combined Spinal Epidural Anaesthesia at a Tertiary Care Hospital Kamala GR 1, Leela GR 2 1 Assistant Professor, Department of Anaesthesiology,
More informationUse of Dexmedetomidine for Sedation of Children Hospitalized in the Intensive Care Unit
ORIGINAL RESEARCH Use of Dexmedetomidine for Sedation of Children Hospitalized in the Intensive Care Unit Christopher L. Carroll, MD 1 Diane Krieger, MSN, CPNP 1 Margaret Campbell, PharmD 2 Daniel G. Fisher,
More informationTITLE: Dexmedetomidine for Sedation of Patients in the ICU or PICU: Review of Clinical Effectiveness and Safety
TITLE: Dexmedetomidine for Sedation of Patients in the ICU or PICU: Review of Clinical Effectiveness and Safety DATE: 16 January 2014 CONTEXT AND POLICY ISSUES Sedation of ICU patients is often essential
More informationThe Addition of Dexmedetomidine as an Adjunctive Therapy to Benzodiazepine Use in Alcohol Withdrawal Syndrome
Original Article Journal of Addictions Nursing & Volume 28 & Number 4, 188Y195 & Copyright B 2017 International Nurses Society on Addictions The Addition of Dexmedetomidine as an Adjunctive Therapy to
More informationEvaluation of efficacy of sedative and analgesic effects of single IV dose of dexmedetomidine in post-operative patients
www.ijpcs.net ABSTRACT Evaluation of efficacy of sedative and analgesic effects of single IV dose of dexmedetomidine in post-operative patients Manasa CR 1 *, Padma L 2, Shivshankar 3, Ranjani Ramanujam
More informationDISSOCIATIVE ANESTHESIA
DISSOCIATIVE ANESTHESIA Adarsh Kumar Dissociative anesthesia implies dissociation from the surrounding with only superficial sleep mediated by interruption of neuronal transmission from unconscious to
More informationDexmedetomidine for Sedation in the Critical Care Setting: An Economic Assessment
CADTH TECHNOLOGY REVIEW Dexmedetomidine for Sedation in the Critical Care Setting: An Economic Assessment Service Line: Technology Review Issue Number: 6 Version: 1.0 Publication Date: March 2017 Report
More informationOriginal Contributions
Original Contributions Use of Dexmedetomidine to Facilitate Extubation in Surgical Intensive-Care-Unit Patients Who Failed Previous Weaning Attempts Following Prolonged Mechanical Ventilation: A Pilot
More informationOver the past 10 years, there has been an increase in
Dexmedetomidine for Sedation During Noninvasive Ventilation in Pediatric Patients Rasika Venkatraman, MD 1 ; James L. Hungerford, MD 2,3 ; Mark W. Hall, MD 1 ; Melissa Moore-Clingenpeel, MS 1,4 ; Joseph
More informationA New Advancement in Anesthesia. Your clear choice for induction.
A New Advancement in Anesthesia Your clear choice for induction. By Kirby Pasloske When using Alfaxan, patients should be continuously monitored, and facilities for maintenance of a patent airway, artificial
More informationDexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial
Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial Xian Su, Zhao-Ting Meng, Xin-Hai Wu, Fan Cui, Hong-Liang Li,
More informationThe evolving approach to sedation in ventilated patients: a real world perspective
Editorial Page 1 of 5 The evolving approach to sedation in ventilated patients: a real world perspective Annachiara Marra 1,2, Pratik P. Pandharipande 3 1 Department of Medicine, Division of Allergy and
More informationDexmedetomidine Versus Midazolam for the Sedation of Patients with Non-invasive Ventilation Failure
ORIGINAL ARTICLE Dexmedetomidine Versus Midazolam for the Sedation of Patients with Non-invasive Ventilation Failure Zhao Huang, Yu-sheng Chen, Zi-li Yang and Ji-yun Liu Abstract Objective To compare the
More informationA SYSTEMATIC REVIEW ON THE USE OF DEXMEDETOMIDINE AS A SOLE AGENT FOR INTRAVENOUS MODERATE SEDATION
A SYSTEMATIC REVIEW ON THE USE OF DEXMEDETOMIDINE AS A SOLE AGENT FOR INTRAVENOUS MODERATE SEDATION by Dr. Samuel Y. Toong A thesis submitted in conformity with the requirements for the degree of Master
More informationHemodynamic effects of dexmedetomidine-- fentanyl vs. nalbuphine--propofol in plastic surgery
Hemodynamic effects of dexmedetomidine-- fentanyl vs. nalbuphine--propofol in plastic surgery Juan F. De la Mora-González *, José A. Robles-Cervantes 2,4, José M. Mora-Martínez 3, Francisco Barba-Alvarez
More informationHaemodynamic and anaesthetic advantages of dexmedetomidine
Haemodynamic and anaesthetic advantages of dexmedetomidine Abstract Rao SH, Assistant Professor Sudhakar B, Associate Professor Subramanyam PK, Professor Department of Anaesthesia and Critical Care, Dr
More informationComparison of several dosing schedules of intravenous dexmedetomidine in elderly patients under spinal anesthesia
Anesth Pain Med 2017;12:320-325 https://doi.org/10.17085/apm.2017.12.4.320 pissn 1975-5171 ㆍ eissn 2383-7977 Clinical Research Received January 11, 2017 Revised 1st, February 28, 2017 2nd, April 4, 2017
More informationGUIDELINES FOR ANESTHESIA AND FORMULARIES
GUIDELINES FOR ANESTHESIA AND FORMULARIES Anesthesia is the act of rendering the animal senseless to pain or discomfort and is required for surgical and other procedures. Criteria for choosing an anesthetic
More informationAssociate Professor, Department of Anaesthesiology, Government Thoothukudi Medical College, Thoothukudi, Tamil Nadu, India, 2
Original Article DOI: 10.17354/ijss/2016/295 Effect of Intravenous use of Dexmedetomidine on Anesthetic Requirements in Patients Undergoing Elective Spine Surgery: A Double Blinded Randomized Controlled
More informationT u l a n e U n i v e r s i t y I A C U C Guidelines for Rodent & Rabbit Anesthesia, Analgesia and Tranquilization & Euthanasia Methods
T u l a n e U n i v e r s i t y I A C U C Guidelines for Rodent & Rabbit Anesthesia, Analgesia and Tranquilization & Euthanasia Methods Abbreviations: General Considerations IV = intravenous SC = subcutaneous
More informationGuidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults)
Guidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults) Community Acquired Pneumonia Community Acquired Pneumonia 1) Is it pneumonia? ie new symptoms and signs of
More informationInvasive and noninvasive procedures
Feature Review Article Dexmedetomidine and ketamine: An effective alternative for procedural sedation? Joseph D. Tobias, MD Objectives: Although generally effective for sedation during noninvasive procedures,
More informationStudy the Effect of Dexmedetomidine on Emergence Agitation after Nasal Surgeries
Original Research Article Study the Effect of Dexmedetomidine on Emergence Agitation after Nasal Surgeries G V Krishna Reddy 1*, S. Kuldeep 2, G. Obulesu 3 1 Assistant Professor, Department of Anaesthesiology,
More informationGuidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults)
Guidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults) Community Acquired Community Acquired 1) Is it pneumonia? ie new symptoms and signs of a lower respiratory
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. Name of the Veterinary Medicinal Product Vetofol 10mg/ml Emulsion for Injection for cats and dogs (AT, CY, EE, FI, DE, EL, LV, PT, ES) Norofol 10mg/ml Emulsion for
More informationTITLE: Dexmedetomidine for Sedation in the ICU or PICU: A Review of Cost- Effectiveness and Guidelines
TITLE: Dexmedetomidine for Sedation in the ICU or PICU: A Review of Cost- Effectiveness and Guidelines DATE: 17 December 2014 CONTEXT AND POLICY ISSUES Sedation of ICU patients is often essential for ICU
More informationStudy of Dexmedetomidine as intramuscular premedication in outpatient cataract surgery: A placebo controlled study
Original Research Article Study of Dexmedetomidine as intramuscular premedication in outpatient cataract surgery: A placebo controlled study D. Srinivasa Naik 1, K. Ravi Kumar 1, Surendra Babu 2, R. Pandu
More information1. NAME AND ADDRESS OF THE MARKETING AUTHORISATION HOLDER AND OF THE MANUFACTURING AUTHORISATION HOLDER RESPONSIBLE FOR BATCH RELEASE, IF DIFFERENT
PACKAGE LEAFLET FOR: Dormilan solution for injection for dogs and cats [FR] Dormilan 1 mg/ml solution for injection for dogs and cats [DE, PT, UK] Reanest 1 mg/ml solution for injection for dogs and cats
More informationPreliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit
Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unit R. M. Venn, 1 C. J. Bradshaw, 1 R. Spencer, 2 D. Brealey, 3 E. Caudwell, 3 C. Naughton,
More informationOriginal Article Dose-dependent effects of dexmedetomidine during one-lung ventilation in patients undergoing lobectomy
Int J Clin Exp Med 2017;10(3):5216-5221 www.ijcem.com /ISSN:1940-5901/IJCEM0012317 Original Article Dose-dependent effects of dexmedetomidine during one-lung ventilation in patients undergoing lobectomy
More informationSummary of Product Characteristics
Summary of Product Characteristics 1 NAME OF THE VETERINARY MEDICINAL PRODUCT Domitor 1 solution for injection 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Active substance: Medetomidine hydrochloride (equivalent
More informationDexmedetomidine: its use in intensive care medicine and anaesthesia
BJA Education, 16 (7): 242 246 (2016) doi: 10.1093/bjaed/mkv047 Advance Access Publication Date: 26 September 2015 Matrix reference 1A02, 2C05, 2A10, 3C00 Dexmedetomidine: its use in intensive care medicine
More informationA Comparative Evaluation of Intranasal Dexmedetomidine and Intranasal Midazolam for Premedication in Pediatric Surgery
Original Research Article A Comparative Evaluation of Intranasal Dexmedetomidine and Intranasal Midazolam for Premedication in Pediatric Surgery Dr. Shweta Nitturi 1*, Dr. Olvyna D souza 2 1 ICU Junior
More informationParthasarathy et al. Sri Lankan Journal of Anaesthesiology: 25(2):76-81(2017)
Comparison of efficacy of intravenous dexmedetomidine with intravenous ketamine in allaying procedural discomfort during establishment of subarachnoid block S Parthasarathy 1*, AJ Charles 2, DR Singh 1,
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE VETERINARY MEDICINAL PRODUCT Medeson 1 mg/ml solution for injection for dogs and cats [AT, CY, CZ, DE, EL, ES, HR, IT, LT, LV, PL, PT, RO, SI, SK] Medeson,
More informationPeriod of study: 12 Nov 2002 to 08 Apr 2004 (first subject s first visit to last subject s last visit)
Study Synopsis This file is posted on the Bayer HealthCare Clinical Trials Registry and Results website and is provided for patients and healthcare professionals to increase the transparency of Bayer's
More informationComparison of Clonidine and Dexmedetomidine on Cardiovascular Stability in Laparoscopic Cholecystectomy
Original Article DOI: 10.17354/ijss/2016/185 Comparison of Clonidine and Dexmedetomidine on Cardiovascular Stability in Laparoscopic Cholecystectomy Devang Bharti 1, Juhi Saran 2, Chetan Kumar 3, H S Nanda
More informationRajaclimax Kirubahar, Bose Sundari, Vijay Kanna*, Kanakasabai Murugadoss
International Journal of Research in Medical Sciences Kirubahar R et al. Int J Res Med Sci. 2016 Apr;4(4):1172-1176 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Research Article DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160804
More informationS Kumar, B B Kushwaha, R Prakash, S Jafa, A Malik, R Wahal, J Aggarwal, R Kapoor
ISPUB.COM The Internet Journal of Anesthesiology Volume 33 Number 1 Comparative Study Of Effects Of Dexmedetomidine And Clonidine Premedication In Perioperative Hemodynamic Stability And Postoperative
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE VETERINARY MEDICINAL PRODUCT Dormilan solution for injection for dogs and cats [FR] Dormilan 1 mg/ml solution for injection for dogs and cats [DE, ES,
More informationDr. Omar S. Tabbouche, M.Sc, D.Sc, Pharm.D Head of Pharmacy Department New Mazloum Hospital Tripoli, Lebanon
Efficacy & Safety of Ketoprofen 25mg vs. Paracetamol 1g intravenous preparations in the management of fever in adults: A pilot, double-blind, parallel-group, randomized controlled trial Dr. Omar S. Tabbouche,
More informationComparison of dexmedetomidine and propofol for conscious sedation in inguinal hernia repair: A prospective, randomized, controlled trial
Research Report Comparison of dexmedetomidine and propofol for conscious sedation in inguinal hernia repair: A prospective, randomized, controlled trial Journal of International Medical Research 2017,
More informationSynopsis. Takeda Pharmaceutical Company Limited Name of the finished product UNISIA Combination Tablets LD, UNISIA Combination Tablets
Synopsis Name of the sponsor Takeda Pharmaceutical Company Limited Name of the finished product UNISIA Combination Tablets LD, UNISIA Combination Tablets Name of active ingredient Title of the study Study
More informationThe comparison of the effects of intravenous ketamine or dexmedetomidine infusion on spinal block with bupivacaine
Clinical Research Article Korean J Anesthesiol 2014 August 67(2): 85-89 http://dx.doi.org/10.4097/kjae.2014.67.2.85 The comparison of the effects of intravenous ketamine or dexmedetomidine infusion on
More informationEfficacy of dexmedetomidine in reducing postoperative morphine consumption in patients undergoing total abdominal hysterectomy
Original Article Brunei Int Med J. 2016; 12 (3): 97-103 Efficacy of dexmedetomidine in reducing postoperative morphine consumption in patients undergoing total abdominal hysterectomy Mazlilah ABDUL MALEK
More informationComparison of dexmedetomidine v/s propofol used as adjuvant with combined spinal epidural anaesthesia for joint replacement surgeries
Comparison of dexmedetomidine v/s propofol used as adjuvant with combined spinal epidural anaesthesia for joint replacement surgeries Kuldeep Chittora 1 *; Ritu Sharma 2 ; Rajeev LochanTiwari 3 1 Department
More informationDr. PratekKoolwal, Dr.BribalBaj, DrKashif M Madani, Dr.MohitSomani, Dr. Vijay Mathur.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-853, p-issn: 2279-861.Volume 14, Issue 7 Ver. VIII (July. 215), PP 84-9 www.iosrjournals.org "Dose related prolongation of hyperbaric
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE VETERINARY MEDICINAL PRODUCT NOSEDORM 5 mg/ml Solution for injection for dogs and cats [DE, ES, FR, PT] 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each
More informationCase Report Dexmedetomidine as a Procedural Sedative for Percutaneous Tracheotomy: Case Report and Systematic Literature Review
Case Reports in Critical Care Volume 2012, Article ID 659415, 4 pages doi:10.1155/2012/659415 Case Report Dexmedetomidine as a Procedural Sedative for Percutaneous Tracheotomy: Case Report and Systematic
More informationDexmedetomidine vs. Propofol for Short-Term Sedation of Postoperative Mechanically Ventilated Patients
Journal of the Egyptian Nat. Cancer Inst., Vol. 16, No. 3, September: 153-158, 2004 Dexmedetomidine vs. for Short-Term Sedation of Postoperative Mechanically Ventilated Patients SAMIA ELBARADIE, M.D.*;
More informationSAFETY PHARMACOLOGY: CARDIOVASCULAR TELEMETRY. Aileen Milne PhD, Manager, Safety Pharmacology
SAFETY PHARMACOLOGY: CARDIOVASCULAR TELEMETRY Aileen Milne PhD, Manager, Safety Pharmacology SAFETY PHARMACOLOGY SERVICES OVERVIEW Full Range of S7A and S7B studies herg assay Respiratory function plethysmography(rat/mouse)
More informationProcedure # IBT IACUC Approval: December 11, 2017
IACUC Procedure: Anesthetics and Analgesics Procedure # IBT-222.04 IACUC Approval: December 11, 2017 Purpose: The purpose is to define the anesthetics and analgesics that may be used in mice and rats.
More informationDexmedetomidine intravenous sedation using a patient-controlled sedation infusion pump: a case report
Case Report pissn 2383-9309 eissn 2383-9317 J Dent Anesth Pain Med 2016;16(1):55-59 http://dx.doi.org/10.17245/jdapm.2016.16.1.55 Dexmedetomidine intravenous sedation using a patient-controlled sedation
More informationTotal Intravenous Anaesthesia (TIVA) in Veterinary Practice
Total Intravenous Anaesthesia (TIVA) in Veterinary Practice Rukmani Dewangan 1, S. K. Tiwari 2 1, 2 Department of Veterinary Surgery and Radiology, College of Veterinay Science and A.H. Anjora Durg (C.G.),
More informationSupplemental Material
Supplemental Material Jakob SM, Ruokonen E, Grounds RM, et al; for the Dexmedetomidine for Long-Term Sedation Investigators. Dexmedetomidine vs. midazolam or propofol for sedation during prolonged mechanical
More informationAlfaxan FAQs. Repeatable. Reliable. Relax.
Alfaxan FAQs INDICATIONS: Alfaxan is indicated for the induction and maintenance of anesthesia and for induction of anesthesia followed by maintenance with an inhalant anesthetic, in cats and dogs. Important
More informationComparison of two doses of intranasal dexmedetomidine as premedication in children
Comparison of two doses of intranasal dexmedetomidine as premedication in children V. Pavithra, M. N. Ramani, S. K. Shah Department of Anaesthesia, B. J. Medical College, Civil Hospital, Ahmedabad, Gujarat,
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE VETERINARY MEDICINAL PRODUCT Xylacare 2% w/v Solution for Injection 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Active substances Qualitative composition
More informationSuitability of Antibiotic Treatment for CAP (CAPTIME) The duration of antibiotic treatment in community acquired pneumonia (CAP)
STUDY PROTOCOL Suitability of Antibiotic Treatment for CAP (CAPTIME) Purpose The duration of antibiotic treatment in community acquired pneumonia (CAP) lasts about 9 10 days, and is determined empirically.
More informationQuality of MRI pediatric sedation: Comparison between intramuscular and intravenous dexmedetomidine
Egyptian Journal of Anaesthesia (2013) 29, 47 52 Egyptian Society of Anesthesiologists Egyptian Journal of Anaesthesia www.elsevier.com/locate/egja www.sciencedirect.com Research Article Quality of MRI
More informationSAFETY AND ACCEPTABILITY
Pulmonary Critical Care SAFETY AND ACCEPTABILITY OF PATIENT-ADMINISTERED SEDATIVES DURING MECHANICAL VENTILATION By Linda L. Chlan, RN, PhD, Debra J. Skaar, PharmD, Mary F. Tracy, RN, PhD, CCNS, Sarah
More informationANNEX I SUMMARY OF PRODUCT CHARACTERISTICS
Butomidor 10 mg/ml - Solution for injection for horses, dogs and cats SPC_labelling_PIL 22 December 2011 [Version 7.2, 12/2008] ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 1 1. NAME OF THE VETERINARY MEDICINAL
More informationSummary of Product Characteristics
Summary of Product Characteristics 1 NAME OF THE VETERINARY MEDICINAL PRODUCT Narketan-10 100 mg/ml Solution for Injection. 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each ml contains: Active substance
More informationStudy between clonidine and dexmedetomidine in attenuation of pressor response during endotracheal intubation
Original Research Article Study between clonidine and dexmedetomidine in attenuation of pressor response during endotracheal intubation K. Selvarju 1, Kondreddi Narayana Prasad 2*, Ajay Kumar Reddy Bobba
More informationN.C. A and T List of Approved Analgesics 1 of 5
1 of 5 Note to user: This list of commonly used analgesics and sedatives is not all-inclusive. The absence of an agent does not necessarily mean it is unacceptable. For any questions, call the Clinical
More informationReview of local guidelines Contributes to CQC Regulation number: 9,11
Dexmedetomidine Infusions in Burns Intensive Care for Adults Clinical Guideline Register No: 15026 Status: Public Developed in response to: Best practice Review of local guidelines Contributes to CQC Regulation
More informationOriginal Article INTRODUCTION. Abstract
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2016/305 Comparison between 0.5 µg/kg Dexmedetomidine with 0.5% Lignocaine and 0.5% Lignocaine Alone in Intravenous for
More informationResearch Article. Amrita Roy 1 *, Suman Sarkar 2, Anirban Chatterjee 2, Anusua Banerjee 3. Received: 11 September 2015 Accepted: 07 October 2015
International Journal of Research in Medical Sciences Roy A et al. Int J Res Med Sci. 2015 Nov;3(11):3238-3244 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Research Article DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151169
More informationEvaluation of dexmedetomine in anesthesia care for elderly patients with obstructive sleep apnea
1 Evaluation of dexmedetomine in anesthesia care for elderly patients with obstructive sleep apnea John Smith Nova Southeastern University 2 Table of Contents Abstract 3 Chapter I: Introduction 4 Statement
More informationHEALTH TECHNOLOGY ASSESSMENT
HEALTH TECHNOLOGY ASSESSMENT VOLUME 20 ISSUE 25 MARCH 2016 ISSN 1366-5278 Alpha-2 agonists for sedation of mechanically ventilated adults in intensive care units: a systematic review Moira Cruickshank,
More informationA cost-minimization analysis of dexmedetomidine compared with midazolam for long-term sedation in the intensive care unit*
A cost-minimization analysis of dexmedetomidine compared with midazolam for long-term sedation in the intensive care unit* Joseph F. Dasta, MSc, FCCM, FCCP; Sandra L. Kane-Gill, PharmD, MSc, FCCM, FCCP;
More informationUniversity of Cape Town
l1li.. I I l1li III I The copyright of this thesis vests in the author. No quotation from it or information derived from it is to be published without full acknowledgement of the source. The thesis is
More informationTELAZOL (tiletamine and zolazepam for injection) IV Induction Claim FAQs 1, 2
TELAZOL (tiletamine and zolazepam for injection) IV Induction Claim FAQs 1, 2 1) Q: What is TELAZOL? A: TELAZOL (tiletamine and zolazepam for injection) is a nonnarcotic, nonbarbiturate, injectable anesthetic
More informationSUMMARY OF PRODUCT CHARACTERISTICS
SUMMARY OF PRODUCT CHARACTERISTICS 1. NAME OF THE VETERINARY MEDICINAL PRODUCT Anaestamine 100 mg/ml solution for injection Aniketam, 100 mg/ml solution for injection (EE/LT/LV) Aniketam vet., 100 mg/ml
More informationInt. J. Pharm. Sci. Rev. Res., 36(1), January February 2016; Article No. 38, Pages: *Corresponding author s
Research Article Comparative Study Betweeen Dexmedetomidine and Remifentanyl for Efficient Pain and Ponv Management in Propofol Based Total Intravenous Anesthesia after Laparoscopic Gynaecological Surgeries
More informationDexmedetomidine and its Injectable Anesthetic-Pain Management Combinations
Back to Anesthesia/Pain Management Back to Table of Contents Front Page : Library : ACVC 2009 : Anesthesia/Pain Management : Dexmedetomidine Dexmedetomidine and its Injectable Anesthetic-Pain Management
More information